外阴阴道念珠菌病复发前后分离菌株基因型分析

Genotyping of Candida strains isolated from patients with vulvovaginal candidiasis before and after relapse

目的比较从外阴阴道念珠菌病患者复发前后分离菌株的RAPD指纹图谱的异同。方法通过流行病学调查表来收集病例和采集样本。所有临床分离菌株均经芽管形成试验、念珠菌显色培养基（CHROMagar Candida）和API20C系统鉴定，然后用RAPD技术对2株白念株菌标准菌株和来自24例患者连续2次及1例患者连续3次分离出的临床菌株共51株菌株进行基因分型。结果引物4的RAPD扩增结果表明，66．7％的患者再次发作前后菌株的扩增带型一致。引物7的RAPD扩增结果为，58．3％的患者复诊前后菌株的扩增带型一致。25例患者中有4例患者前后2次分离的菌种从白念珠菌替换成光滑念珠菌。结论从外阴阴道念珠菌病患者分离的菌株半数以上在再次发作前后无明显基因型上的差别，仅有部分菌株会在复发前后基因型发生改变。

Objective To compare the genotypes of Candida strains isolated from patients with vulvovaginal candidiasis before and after relapse. Methods Candida strains were isolated from 25 patients with vulvovaginal candidiasis before and after relapse, and identified with germ tube formation tests, CHROMagar Candida and API20C system. Candida isolates were genotyped by random amplified polymorphic （RAPD） with 9 primers. Results Two Candida strains were isolated from each of the patients; however, in one patient, three strains were isolated. A total of 51 Candida strains were isolated from these patients. Fortyseven strains were identified as C. albicans and 4 as C.glabrata. C. albicans was replaced by C. glabrata in 4 cases after the relapse of vulvovaginal candidiasis. The RAPD profiles of Candida were identical before and after the relapse in 66.7% of the patients as assessed with primer 4, and in 58.3% with primer 7. Conclusions This study shows that more than half of the relapse of vulvovaginal candidiasis is caused by the same type of Candida, and only a small part by different types of Candida.